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PROTECT Yourself & Others from Yeast Infection

1. What is a yeast infection?
   A yeast infection is caused by an overgrowth of naturally occurring yeast organisms in the genital area. Women usually get yeast infections in the vaginal area. Men can get a yeast infection on the penis.

2. What causes a yeast infection?
   Yeast infections are not usually sexually transmitted. Although many women get a yeast infection without any noticeable cause, it can be triggered by anything that changes the natural balance of micro-organisms in the vagina, such as taking antibiotic medication. People with certain diseases, including diabetes and HIV infection, are especially vulnerable to yeast infections.
3. What are the symptoms of a yeast infection?
   Symptoms may include itching, soreness, or a burning sensation in the vagina, and a thick, cottage-cheese-like discharge. In men, itching and rash at the head of the penis is the most common symptom.
4. How will I know if I have a yeast infection?
   For women, your doctor or other health-care provider will collect a sample of fluid with a small swab from the vagina and have it tested at a laboratory. For men, a yeast infection can usually be diagnosed by a simple visual exam.
5. How is a yeast infection treated?
   Medicated creams, vaginal suppositories, or pills taken by mouth can be used to cure a yeast infection. Many of these treatments are available without a prescription at drugstores. You should see a doctor if your yeast infection won’t go away after you’ve taken a full course of medication, or if it keeps returning, as there may be other causes of your symptoms.
6. What happens if a yeast infection is left untreated?
   Discomfort and inconvenience are the worst problems associated with a yeast infection.
7. Do sex partners have to be treated?
   In general, sex partners do not need to be treated unless they have symptoms.
8. What if I’m pregnant?
   We don’t know of any serious effects on the mother or the baby of a yeast infection during pregnancy, but you should tell your doctor that you’re pregnant when you seek treatment for a yeast infection. A yeast infection is not usually sexually transmitted. However, all pregnant women should be tested for diseases that ARE sexually transmitted (STDs), including HIV, as early as possible in pregnancy.You should be tested again during your pregnancy if you or your partner engage in activities that increase your risk of getting a sexually transmitted disease (STD). For example, you are at higher risk for STDs if you have a new sex partner during pregnancy, or if you have more than one partner. If left untreated, STDs can be devastating for your baby. To protect yourself and your baby against HIV and other STDs, use a latex condom whenever you have sex.
9. How can I avoid a yeast infection?
   Avoiding unnecessary antibiotic medication may help reduce the risk of a yeast infection. A yeast infection is generally not sexually transmitted. You can reduce your risk of getting most other infections that ARE sexually transmitted, including HIV, by having sex only in a mutually monogamous relationship with a partner you are sure is not infected. If you are having sex outside of such a relationship, you can reduce your risk of STDs by:
   1) Always using a latex condom (or other type of latex barrier) whenever you have sex vaginal, anal, or oral. Condoms made of “natural”materials, such as lambskin, protect against pregnancy, but not against STDs. If you are allergic to latex, you can use condoms made of polyurethane or other synthetic materials.
   2) Limiting the number of people you have sex with. The more partners you have, the higher your risk.
   3) Avoiding alcohol and drugs when you have sex. Drinking or getting high makes it much harder to remember to use condoms to protect yourself and others. For free, confidential help with a substance abuse problem, call 1-800-LIFENET (1-800-543-3638), or just call 311.

More information : Free, confidential STD exams and treatment, and confidential or anonymous HIV counseling and testing, are available at Health Department clinics in all 5 boroughs of New York City. Health insurance, proof of citizenship, and parental consent are NOT required. For a list of clinics and hours, visit http://www.nyc.gov/health, or call 311.

The New York City Department of Health and Mental Hygiene
Michael R. Bloomberg, Mayor
Thomas R. Frieden, M.D.,M.P.H., Commissioner

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Frequently Asked questions for Vaginal Yeast Infections
by: U.S. Department of Health and Human Services, Office on Womens Health

Vaginal Yeast Infections

Q : What is a vaginal yeast infection?
A : A vaginal yeast infection is irritation of the vagina and the area around it called the vulva (vul-vuh). Yeast is a type of fungus. Yeast infections are caused by overgrowth of the fungus Candida albicans. Small amounts of yeast are always in the vagina. But when too much yeast grows, you can get an infection. Yeast infections are very common. About 75 percent of women have one during their lives. And almost half of women have two or more vaginal yeast infections.

Q : What are the signs of a vaginal yeast infection?
A : The most common symptom of a yeast infection is extreme itchiness in and around the vagina.
Other symptoms include:
• burning, redness, and swelling of the vagina and the vulva
• pain when passing urine
• pain during sex
• soreness
• a thick, white vaginal discharge that looks like cottage cheese and does not have a bad smell
• a rash on the vagina
You may only have a few of these symptoms. They may be mild or severe.

Q : Should I call my doctor if I think I have a yeast infection?
A : Yes, you need to see your doctor to find out for sure if you have a yeast infection. The signs of a yeast infection are much like those of sexually transmitted infections (STIs) like Chlamydia (KLUH-mid-ee-uh) and gonorrhea (gahn-uh-REE-uh). So, it’s hard to be sure you have a yeast infection and not something more serious. If you’ve had vaginal yeast infections before, talk to your doctor about using over-the-counter medicines.

Q : How is a vaginal yeast infection diagnosed?
A : Your doctor will do a pelvic exam to look for swelling and discharge. Your doctor may also use a swab to take a fluid sample from your vagina. A quick look with a microscope or a lab test will show if yeast is causing the problem.

Q : Why did I get a yeast infection?
A : Many things can raise your risk of a vaginal yeast infection, such as:
• stress
• lack of sleep
• illness
• poor eating habits, including eating extreme amounts of sugary foods
• pregnancy
• having your period
• taking certain medicines, including birth control pills, antibiotics, and steroids
• diseases such as poorly controlled diabetes and HIV/AIDS
• hormonal changes during your periods

Q : Can I get a yeast infection from having sex?
A : Yes, but it is rare. Most often, women don’t get yeast infections from sex. The most common cause is a weak immune system.

Q : How are yeast infections treated?
A : Yeast infections can be cured with antifungal medicines that come as:
• creams
• tablets
• ointments or suppositories that are inserted into the vagina. These products can be bought over the counter at the drug store or grocery store. Your doctor can also prescribe you a single dose of oral fluconazole (floo-con-uh-zohl). But do not use this drug if you are pregnant. Infections that don’t respond to these medicines are starting to be more common. Using antifungal medicines when you don’t really have a yeast infection can raise your risk of getting a hard-totreat infection in the future.

Q : Is it safe to use over-the-counter medicines for yeast infections?
A : Yes, but always talk with your doctor before treating yourself for a vaginal yeast infection if you:
• are pregnant
• have never been diagnosed with a yeast infection
• keep getting yeast infections. Studies show that two-thirds of women who buy these products don’t really have a yeast infection. Using these medicines the wrong way may lead to a hard-to-treat infection. Plus, treating yourself for a yeast infection when you really have something else may worsen the problem. Certain STIs that go untreated can cause cancer, infertility, pregnancy problems, and other health problems. If you decide to use these over-thecounter medicines, read and follow the directions carefully. Some creams and inserts may weaken condoms and diaphragms.

Q : If I have a yeast infection, does my sexual partner need to be treated?
A : Yeast infections are not STIs, and health experts don’t know for sure if they are transmitted sexually. About 12 to 15 percent of men get an itchy rash on the penis if they have unprotected sex with an infected woman. If this happens to your partner, he should see a doctor. Men who haven’t been circumcised are at higher risk. Lesbians may be at risk for spreading yeast infections to their partner(s). Research is still being done to find out. If your female partner has any symptoms, she should also be tested and treated.

Q : How can I avoid getting another yeast infection?
A : To help prevent vaginal yeast infections, you can:
• avoid douches
• avoid scented hygiene products like bubble bath, sprays, pads, and tampons
• change tampons and pads often during your period
• avoid tight underwear or clothes made of synthetic fibers
• wear cotton underwear and pantyhose with a cotton crotch
• change out of wet swimsuits and exercise clothes as soon as you can
• avoid hot tubs and very hot baths. If you keep getting yeast infections, be sure and talk with your doctor.

Q : What should I do if I get repeat yeast infections?
A : Call your doctor. About 5 percent of women get four or more vaginal yeast infections in 1 year. This is called recurrent vulvovaginal candidiasis (RVVC). RVVC is more common in women with diabetes or weak immune systems. Doctors most often treat this problem with antifungal medicine for up to 6 months.

For more information about yeast infections, call the National Women’s Health Information Center (NWHIC) at 1-800-994-9662 or contact the following organizations:

1. National Institute of Allergy and Infectious Diseases, NIH, HHS
   Phone number: (866) 284-4107
   Internet address: www.niaid.nih.gov/publications/stds.htm
2. Centers for Disease Control and Prevention, HHS
   Phone number: (800) CDC-INFO or (800) 232-4636
   Internet address: www.cdc.gov
3. CDC National Prevention Information Network (NPIN), CDC, HHS
   Phone number: (800) 458-5231
   Internet Address: www.cdcnpin.org
4. American College of Obstetricians and Gynecologists
   Phone number: (800) 762-2264 (for publications requests only)
   Internet address: www.acog.org
5. Planned Parenthood Federation of America
   Phone number: (800) 230-7526 or (800) 230-PLAN
   Internet address: www.plannedparenthood.org
6. Association of Reproductive Health Professionals
   Phone number: (202) 466-3825
   Internet address: www.arhp.org/
7. National Women’s Health Resource Center
   Phone number: (877) 986-9472
   Internet address: www.healthywomen.org/healthtopics/yeastinfections
8. American Academy of Family Physicians (AAFP)
   Internet address: http://familydoctor.org

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Source : http://www.womenshealth.gov

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First Aid Quick Reference
Yeast Infection Skin Rash Treatment

Self – Care at Home
Most candidal infections can be treated at home with over-the-counter or prescription medication and can clear up within a week. If some other disease has weakened a person’s immune system, the person should consult a doctor about any new symptoms before attempting self-treatment because of the risk of infection.

Vaginal yeast infections

• Most women can treat vaginal yeast infections at home with nonprescription vaginal creams or suppositories.
• A single dose of fluconazole (Diflucan) tablet also cures most vaginal yeast infections. Fluconazole requires a prescription from your physician.

Thrush

• For thrush, swish the antifungal agent nystatin around in your mouth then swallow the liquid.Take care to maintain excellent oral hygiene.
• All objects put into a child’s mouth should be washed or sterilized after each use.
• Breastfeeding mothers should be evaluated for Candida infection of the breast.
• If you wear dentures, clean them thoroughly after each use and practice good oral hygiene.
• Adults and older children have several treatment options not available to babies, such as troches (antifungal lozenges) or pills such as fluconazole (Diflucan) to help clear the infection in addition to nystatin.

Skin and diaper rash

• Clotrimazole (Lotrimin) creams and lotions can be applied to superficial skin infections. Other medications require a prescription and a visit to your doctor.
• Other antifungal creams, such as ketoconazole (Nizoral), which is available by prescription, is helpful as well.
• For paronychia, avoiding moisture can be helpful. Oral itraconazole (Sporanox) or fluconazole (Diflucan) can also be helpful and can be prescribed by a doctor. Topical antifungal and topical corticosteroids are also used.
• Perlèche is treated with topical antiyeast or antifungal agents, and often with a mild corticosteroid cream. Limit lip licking of the corners of the mouth. Placing a bit of petroleum jelly on top of the antiyeast agents can be helpful as well.
• The affected area should be kept clean and dry.
• For diaper rashes, frequent diaper changes and the use of barrier creams speed recovery.
• Intertrigo can benefit from the use of nystatin powder , which decreases the amount of moisture and also acts as an antiyeast agent.

Medical Treatment
A wide array of treatment options is available to treat candidiasis. Options include creams, lotions, tablets or capsules, troches (lozenges), and vaginal suppositories or creams. Talk to your doctor to find the option that is right for you.

• Azole medications are a family of antifungal drugs that end in the suffix “-azole.” They block the manufacture of ergosterol, a crucial material of the yeast cell wall. Without ergosterol, the yeast cell wall becomes leaky and the yeast die. Fortunately, ergosterol is not a component of human membranes, and azoles do not harm human cells.
• Polyene antifungal medications include nystatin and amphotericin B. Nystatin is used for thrush and superficial candidal infections. Doctors reserve amphotericin B for more serious systemic fungal infections. The antifungals work by attaching to the yeast cell wall building material, ergosterol. These medications then form artificial holes in the yeast wall that cause the yeast to leak and die.

Please call 911 if you think you have a medical emergency.

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Source : http://www.emedicinehealth.com

Clinical And Diagnostic Laboratory Immunology
American Society for Microbiology
Hepatitis Viruses Section, Laboratory of Infectious Diseases, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, Maryland.

Sera used to identify putative hepatitis E viral proteins expressed in Pischia pastoris produced a false-positive reaction because of antibodies to a yeast protein. This report illustrates a potential problem when serological reagents are used in combination with recombinant proteins expressed in yeast.

Bacteria (e.g., Escherichia coli), yeasts (e.g., Pischia pastoris) and mammalian cells (e.g., CHO cells) are frequently used as substrates for the expression of recombinant proteins. One such use is for the development of serologic tests for the detection of antibodies to the expressed antigenic proteins.

Alternatively, expression systems may be used to identify uncharacterized proteins. However, infection with organisms related to those used for expression of the recombinant antigens can lead to the development of antibodies to the expression system, with the potential for false-positive antibody tests.

We demonstrate here how a probable P. pastoris infection, temporally related to an experimental infection with hepatitis E virus (HEV), led to an initial erroneous interpretation of serologic data.

An attempt to express open reading frame 1 (ORF1) of HEV in P. pastoris was made by standard procedures (Invitrogen, San Diego, Calif.). ORF1 has the potential to encode a polypeptide or group of polypeptides with a total size of 200 kDa. However, the products of ORF1 have not been identified, and standardized serological reagents have yet to be developed.

Therefore, crude extracts of transformed yeast cultures were evaluated for the presence of the putative antigen by comparison of Western blots (immunoblots) of preinfection and convalescent sera of a chimpanzee that had been experimentally infected with HEV previously (1).

The assumption was that antibodies unique to the convalescent serum would be specific for HEV antigens. To test the specificity of the reaction, preinfection serum from the chimpanzee that was obtained in 1986 before an experimental infection with HEV and hyperimmune convalescent serum that was obtained following a second challenge of the chimpanzee with HEV in 1989 were tested at a 1:100 dilution against the crude yeast lysate by Western blotting. A 200-kDa band was detected only with the convalescent serum, consistent with specificity for one or more HEV-encoded proteins.

However, apparent seroconversion to a 200-kDa band was also observed after extracts of P. pastoris cells which had not been transfected with the HEV ORF1 expression plasmid were used as an antigen in Western blots of the preinfection and convalescent sera. Additional sera were evaluated by enzyme-linked immunosorbent assay (ELISA) as described previously (1), with slight modifications.

Convalescent serum samples from 11 of 12 HEV-infected cynomolgus monkeys and the infected chimpanzee were positive by ELISA. However, some preinoculation sera were also positive by ELISA, suggesting prior HEV infection or reactivity with antigens unrelated to HEV infection.

A more extensive analysis was performed with additional serial serum samples obtained from the chimpanzee. For purposes of comparison, the serum samples were also tested in an ELISA based on a well-characterized recombinant antigen expressed from ORF2 (capsid protein) of HEV in insect cells (1).

Antibody to the capsid protein of HEV was detected in a pattern consistent with the challenge and rechallenge of the chimpanzee with HEV. The animal was seronegative prior to the first challenge, seroconverted postchallenge, maintained detectable antibody until the second challenge, and demonstrated an anamnestic response following the second challenge.

The demonstration of the reactivity of the chimpanzee sera to normal yeast extract, in addition to the demonstration that antibody responses to yeast and to HEV were not superimposable, led to the correct conclusion that the attempt to transform yeast with a plasmid containing ORF1 of HEV was unsuccessful.

This experience emphasizes the importance of meticulous recordkeeping and the use of complete controls. As yeast-based systems are used more frequently for the expression of foreign antigens, the problem of naturally acquired yeast infections and of a resulting serum reactivity to the yeast proteins becomes more important.

We would like to thank Doris Wong for the care of sera, Ying Huang for teaching and assistance, Gopa Raychaudhuri for helpful discussion, and Max Shapiro and the staff of BIOQUAL, Inc., for excellent animal care.

REFERENCE
Tsarev, S. A., T. S. Tsareva, S. U. Emerson, A. Z. Kapikian, J. Ticehurst, W. London, and R. H. Purcell. 1993. ELISA for antibody to hepatitis E virus (HEV) based on complete open reading frame-2 protein expressed in insect cells: identification of HEV infection in primates. J. Infect. Dis. 168:369–378. VOL. 3, 1996 NOTES 615 by on November 17, 2009 cvi.asm.org

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Source : cvi.asm.org